The following papers are approved by the Texas Department of Insurance for Continuing Education.
At the conclusion of this course licensees will learn the major aspects of E&O coverage. Licensees will be able to
recognize the challenges today’s insurance environment presents to insurance agents in connection with E&O issues.
Finally, licensees will know ways to avoid the use of E&O coverage and E&O lawsuits.
At the conclusion of this course licensees will learn the appropriate roles of independent adjusters, private investigators
(both background and cause and origin), attorneys and company claim representatives in the investigation and evaluation of
insurance claims. Each profession serves an important purpose in the claim process. However, all too often, these professionals
are asked to provide opinions that are beyond the scope of their profession. When this happens, the claims process breaks down causing
unfortunate results that usually involves litigation where the insurance company, as well as the professional, becoming involved.
This course will address insurance policies within the context of bad faith allegations. In order to provide a proper understanding
of how bad faith allegations apply with regard to insurance agreements and the strategies utilized in handling such cases, this course
will provide information on the following topics of interest: Evolution of Contract Law; Insurance Policies as Contracts; What is the duty
of good faith and what damages can be recovered from an insurance company that denies coverage in bad faith; How does an insured “get
to” damages on bad faith claims; What strategic decisions are available for bad faith claims?
One of the most challenging duties of a trial judge is to reconcile rules of evidence with new technology. Emerging technology has always
been a part of the changing face of litigation. From fingerprint testimony to DNA testing, trial judges have struggled over the years in
determining whether technological advances should form a basis of making determinations in our judicial system. Digital photographs are now
part of that process.
The purpose of this paper is to provide you with basic information relating to jewelry, fur and fine arts claims. These claims are, at times,
very difficult to evaluate. Many times, these claims involve not only the real value of the items taken, but also issues involving underwriting,
policy language, security issues and potential fraud. As a result, many challenges are presented to the professional insurance adjuster when tackling
jewelry, fur, or fine art claims.
Almost all insurance policies that provide property coverage contain a provision requiring the policyholder to submit to an examination under
oath if requested by the company. Examinations under oath are probably the most powerful tool that an insurance company has in obtaining information
from which to make a claim determination.
The most critical time in the agent/policyholder relationship arises at the moment that a loss is reported to the agent. Years of effective marketing
can be lost at that critical moment. This is not to mention the genuine desire on the part of most agents to assist their clients. However, out of
genuine concern, agents can unwittingly expose themselves to tremendous liability. The purpose of this paper is to explore ways in which an agent can
be truly helpful during the claims process while at the same time avoiding agent liability.
The vast majority of claim files never make their way to an attorney, much less the courthouse. However, for those few claim files that do become evidence
at trial, it is important that the claims representative handle every claim file as if it were to become Exhibit “A” at a trial and he/she were
on the witness stand explaining the contents of that file. Many claim representatives believe that their claim file will never see the light of day, except
perhaps to a supervisor or reinsurance representative. More often than not, attorneys representing policyholders and claimants seek to obtain insurance
company claim files through discovery.
The cost of fraudulent insurance claims in the United States is estimated to be $120 billion per year. Even though the majority of fraud involves healthcare
claims, a significant portion involves property and casualty claims submitted to private insurance companies. Claims representatives are on the front line of
fighting this never ending war against insurance fraud. The purpose of this paper is to assist the claims representative in developing the skill of recognizing
potentially fraudulent claims and fighting them in the courthouse.
The purpose of this presentation is to provide assistance in conducting an evaluation of insured status. By conducting a proper evaluation using the analysis
provided, the goal of preventing serious mistakes in the analysis of Homeowner’s insurance claims can be achieved.
A mediator in Texas has a motto. . . A closed file is a happy file. The purpose of claim representatives and legal professionals is to
effectively resolve disputes in a reasonable and cost effective manner. Ordinarily, the anxiety level rises when a decision is made not to
settle a case, but instead proceed to trial. The purpose of this presentation is to focus on the dangers of settlement. The discussion will
involve both first party, third party, and subrogation claims.
The purpose of this paper is to make sure that I continue to have an active practice representing insurance agents in litigation involving
insureds. As a result, this paper is dedicated to informing insurance agents as to how they can make sure that they will always have lawsuits
filed against them. It is our fervent hope that you will seriously consider these measures to expose yourself to significant liability!
Adjusters, attorneys, and investigators are routinely called upon to take recorded interviews. Unfortunately, they have had little or no
training as to properly conduct a recorded interview. The purpose of this paper is to provide the participant with some legal analysis relating
to recorded interviews, but mostly practical tips on how to effectively conduct a recorded interview.
At the conclusion of this course, licensees will be able to identify the nature of the litigation strategy that is applicable to hurricane
cases, the legal and practical effects of being sued and what to do when you are sued. Licensees will also be able to recognize the challenges
that today's insurance environment presents to adjusters who are involved in hurricane litigation. Finally, licensees will learn about actions
that can be taken now to prevent disaster in the future.
This paper will address the practical and legal aspects of cooperation between insurance companies and government agencies as well as
investigation strategies in cases involving denial of coverage, including arson. There is a delicate balance which must be maintained
in order to thoroughly and efficiently conduct arson investigations, facilitate cooperation between insurance companies, investigators and
government officials, and still stay within the legal lines. Areas of discussion will include cooperation between insurance companies and
government officials, the exchange of information while avoiding the ugly specter of collusion, tools of investigation, and the do's and
don'ts of conducting investigations. Additionally, this discussion will include evaluating evidence relating to fire and arson investigations,
the use of evidence at trial, and some litigation decisions related to arson claims. This paper is not intended to be an exhaustive treatise,
nor is its purpose to provide a set procedure to be applied in every cases. Each case is different and flexibility is important. The advice
of competent and independent legal counsel is critical.
